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.7/12 - 7/20

PLEASE PRAY FOR HER!!!! Acute Leukemia ALL Leukemia and ARDS.

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July 20th -  Michelle continues to fight, she is now making red blood cells and platelets, although she is using the platelets as quickly as she makes them.  SATS prone and supine stay in the 90's.   Liver enzymes are ever more slightly improved,  kidneys remain functional and no fever during the night.   Michelle could use a few more "good" days.   The doctors and nurses continue to take exceptional care for Michelle, please thank them as you have the opportunity. This morning Michelle was supine for over 3 hours but her blood gases were not great so they moved her back on her front once again. She still remains in very critical condition and is monitored closely every minute.

Her temperature went from too high a few days ago to too low this afternoon so they needed to cover her up and crank up the heat. They are trying to get her into the supine position longer and longer each day which will help with her blisters and swelling.  She had lots of friends visit her today (some of the Aquinas College gang) showing their support during her fight.  She still remains on the oscillating vent and rotoprone bed and this makes her 14th day in ICU and her 37th day in the hospital.

*Then your light shall break forth like the dawn, and healing shall spring up quickly.
Isaiah 58:8

Army ShelfJuly 19th-Michelle had a decent night last night with her SAT and blood work better than yesterday morning.  She was able to lay supine for around 1 hour 30 minutes last night which was great and allowed them to do some work on her front side.  Her kidneys are still working (yesterday they were talking about possibly putting her on dialysis ) which is positive.  Her liver blood work is still high but down a little from yesterday.  Lung X-ray is still the same as yesterday but no worse. We need her organs to hang in there and continue working . Please continue to pray for a miracle that Michelle can get through this....

1:30 pm- Michelle managed to stay supine for 4 hours- that is what they wanted her to do today....and her numbers were good during the flip. Now she's prone and still pulling in good high numbers....we are happy with her SAT for now.  Keep up those wonderful prayers!!!

*On another note: while you are saying prayers, Michelle's grandfather Sedlecky will be at Spectrum Hospital in GR today having an angioplasty on his heart. Please also include him in your prayers as Michelle would want that. (*Update- Everything is fine with gramps!!!)

10:30 pm. Update, this was a good day (remember there will be some not good days ahead) SAT up to 95-98, Ventilator pressure slightly lower, temperature normal all afternoon, kidneys hanging in there and spending quality time supine (about 7 hours).  Some of Michelle's friends were up and her heart rate went from 145 beats per minute to about 130 as they talked where she could hear them.

A strange mix of army men and angels continue to look out for Michelle's health.

July 18th- Michelle was supine for over two hours last night with good SAT (blood gases) but the blood work didn't come back to support it.  Shortly after she went back into the prone position her temp spiked to 104- and the blood pressure also decreased.  She was put on meds to keep that up into more normal ranges.  Her kidney's are not working well today.  During recovery of ARDS kidney and liver  failure are common.   We are still holding on to one of the nurses comments earlier this week- that things usually get much worse better they can get better- Still struggling with the fact that here in the ICU unit there is no team leader or master plan...every 12 hour shift we get a new idea from the new ICU doctor working.  One wants her to stay on the oscillator vent / or rotoprone bed and then during the next shift the another one doesn't.

The number on her screen is measured by a devise on her finger is her SAT.

Oxygen content (O2CT) and oxygen saturation (O2Sat) values. O2 content measures the amount of oxygen in the blood. Oxygen saturation measures how much of the hemoglobin in the red blood cells is carrying oxygen (O2).

When they take a blood the measure the PaO2 and O2CT.

Partial pressure of oxygen (PaO2). This measures the pressure of oxygen dissolved in the blood and how well oxygen is able to move from the airspace of the lungs into the blood.

Until recently the two (O2CT and O2SAT) were very close, however, they seem to be 4-7% different lately.

It is so wonderful to have all the prayers, love and support from everyone.  Relatives and friends have come in from all over to be with us and help us out during this rough time.  We appreciate every little prayer, email/snail mail and visit we get even though we may not have thanked you personally. Michelle's condition has worsened but we still believe in miracles.  During the day her SAT were better than in the morning and some of her lab work improved slightly, like her kidneys were working better than the night before.  Lung X-rays were a tad worse however. 

July 17th- 9:30am- We are still waiting to hear if Michelle is going to be able to go to U of Michigan for treatment.  She still needs to meet some criteria in order for the procedure and AIR-O med to take place. St. Mary's and U of M are in consultation on going.  We are hoping she remains stable enough to be able to go.  Her stats, and temperature were consistent throughout the night but she needs to retain them as they  put her supine for over an hour.  The procedure they hope to do is similar to a by-pass, but on the lungs from the femoral vein to the femoral artery to oxygenate the blood so her lungs could heal.

3:00PM- after waiting for hours...it was determined that Michelle is not a candidate for the ECMO procedure due to her present condition.  It would be too risky to move her, or even perform any surgery on her at this time. This doesn't mean we are giving up....just another big set-back.  Thanks to everyone who offered to help us when we thought we were heading southeast (locate housing, watching the dog, prayers, cheer-leaders , etc.). 

Her blood work is showing signs of liver distress probably due to her heart / lung problems . Mike continues to get discouraged with the ups and downs of the ventilator progress and has made a spreadsheet/ bar graph of her Oxygen levels to demonstrate his theory with her proning/supine periods. (His techie mind is always working)   She continues to be on the rotating bed and gets flipped every 10-12 hours or so.  We continue to hang on to all the success stories the nurses and staff share about others who have overcome serious illnesses similar to hers.  So pray she becomes one of those stories as well.

July 16th - Michelle's condition remains consistent without improvement.  A new option has been presented.  Transferring her to University Of Michigan hospital using their ECMO unit for transport. A team will assess her condition tomorrow and if she still is a candidate we will progress to that facility for them to treat her.  St. Mary's Hospital has reached there limit in care they provide for the condition she has currently. PRAYERS PLEASE!!!!

She continues on the ventilator.  The respiratory technicians are adjusting it frequently to balance her CO2 levels, pH and pO2.  Yesterday her blood test results showed that she is no longer nuetropenic, however nuetropenic precautions remain in effect. We were told yesterday that a typical ICU experience does have good days followed by bad days.  We'll today we are feeling it's one of the bad ones...the supine flip had complications with the hoses and now she's slow to recover from the SAT decline.  Yesterday the flips went much better.  No improvement noted on today's AM X-ray is also a little discouraging to us here.

Matthew Asleep
July 15th-
8:30am currently being turned supine, and time to do bathing, Chest X-ray, changing tubes, and other needed things while she is in an upright position.  2 - 3rd shift nurses from Lacks came by to visit (one was the one who worked the night of the fall and blackout...and the other was the one who was working the night of the rigors and the night we ended up here in ICU.  Sue (Ventilator technician) left this morning to return home- she must have been confident with the respiratory team here at St. Mary's to run the machine.  Throughout the night they tried and tweaked the vent to a good pressure Michelle could handle.  They were unsuccessful in getting in the ART line and maybe after more platelets they will attempt this once again. We are awaiting the results of the latest Chest X-ray to see what it shows and the results of the blood work to see if some of her infections are getting a little under control.  The lung condition (ARDS) is what we really needed to get a handle on. 

The ART line was successfully put back in so we now have more actuate numbers to go by and also able to get blood gas results which are real important.  Michelle's stat's are still consistent but the X-ray didn't really show any improvement as of yet. Her Bone Marrow is showing signs of recovery - there are White Blood Cells and Neutrophils, we are expecting platelets in a few days, then red blood cells after that. Her blood work shows some small signs of improvements in some areas which we are taking as a positive response.   She received blood and palettes' today.

The Slacker (seen in the picture a.k.a. younger brother Matt) is hanging in there and catching some zzzz's where ever he can.

*For those of you who wanted to know if there is anything they can do....we'll  there is..."Give blood , or platelets" soon as the blood supply is getting tight and Michelle is requiring a lot for her treatment.

July 14th - The night was quiet, her SATS stayed great, resulting in O2 being at 85% this morning.  The blood work looks good, the bed treatment (3 hrs prone, 1 hour supine) is going well.  The only big thing planned for the day is a ART line - this is like a IV except in the artery.  The ART is used to draw blood and monitor Blood Pressure.

Her platelets remained low after transfusion (remember to give blood Monday) so replacing the ART line was not attempted.  She has been supine (on her back) several times today, overnight she will spend some additional time on her stomach.  She tolerates a lower pressure on her stomach from the ventilator and there is some air (tiny bit) seeping out of her lungs into the tissue by the heart.  This was caught early. If due the higher pressure it had seeped outside the lungs differently she would have collapse a lung and required a air tube installed.  She certainly doesn't need any more tubes.

On a high note her White Blood Cells were 2000 tonight (4-5 thousand are normal), we will see about those nuetrophils in the morning.  Hey were are down to 5 pumps pumping (from 9-11) things into her for the moment.
During the recovery period she will have good days and bad days, there will be ups and downs.  Mitch and I decided that we were ready for more good days than bad.
July 13th- She rested throughout the night and her O2 levels continued to rise slowly.  Now at 7:50am up in the low 90's and that is almost in the normal range. (92-100% is ideal). She's not on blood pressure medicine any more and has received her second bag of food.  Her rash she's had on her back (from antibiotic reaction) is improved.  I (Sue) was able to go home and sleep- after 2 days without any, and Mike is planning on going home for some sleep and a shower which he hasn't had in 2 days.   The private small family conference room which the hospital has allowed us to use is now a make shift- sleeping room for us here at the hospital. The big hurdle today is trying once again to get her on her back for some time to relieve pressure in her face, chest etc.  She has always been unable to tolerate this position so far...but we are more confident now with the new Sensor Medics oscillating ventilation machine. Her Cancer doctor was just in and she's reported to have some white blood cells now- helping her with her fight.  (Not much but some better than none) We are waiting for blood results and another chest X-ray to see if they can see any improvement.  She has gone from 10- IV bags/drips to now only 8.  Her chemo is still on hold until she is stable enough to tolerate it. 

The machine works different from the last.  The first ventilator work like you were taking 20-30 normal to deep breaths a minute. This one keeps her lungs under pressure and replaces a little bit at time (like you are panting really fast with your lungs full). Please keep up all the prayers as we now have a small glimmer of hope.

 Some very positive things from the last 24 hours;

  • New respirator maintaining her vitals (Blood Oxygen)
  • Nuetrophils  are starting to grow
  • Last E-Coli culture (test) was clear
  • She is on 95% Oxygen instead of 100%
  • Her chest X-Rays indicate improvement
  • Heart rate is down and Blood Pressure is normalizing

Concerns about some of the dips in Oxygen and Leukemia remain.  Michelle remains in critical condition as longs as she requires a respirator and maybe beyond.  Her recovery time from these infections will be measured in weeks, as things will progress very slowly.

 

July 12th- (midnight- currently 5am) Her Uncle Charlie spent the night recording her dips and rises on a piece of paper trying to figure out what side/way/position she would get the best oxygen at and try and keep her positioned there the longest...(He's definitely in the running for uncle of the year) At 3am she started trying to breathe on her own (fighting the respirator) which is a sign she is fighting.  They immediately tweaked the machine and her oxygen level rose a bit.  Lots of excitement for us all still here at the hospital (Dad, Mom, Aunt Katie, Mitch, and Uncle Charlie) she rose 5-6 points, Baby steps...some of us are trying to sleep in chairs, couches, and however we can.  Others (Charlie- working on adrenaline and drinking coffee.) She is receiving IV food now...first meal in 5 or six days.  All of her other vitals are showing some improvement except her breathing.  *Not sure what the staff here thinks about us...we cheer for every increase in oxygen level and bribe her with money and trips for small oxygen increases as well.  Her uncle Richie promised her a raise, mom a trip to Vegas, and she's making some cash as well with our bribes to cover her gambling expenses. (she shouldn't remember any of this) This is just some of the little things we do to pass the time, and help Michelle with her fight. We have her toy soldiers positioned around her room helping her fight these infections since she doesn't have any immune system to work on her own.  Most of here don't know what day or time it is...and this journal is a great help to us to recall/remember when she had procedures and what day we are on.  On a good note her kidneys are doing a good job now and are trying hard to release some of the excess fluid she's retaining...please ignore any grammar and spelling problems, to sleepy to proof-read.

9:30am- still up here... Her Lung doctor has ordered a new high tech jet vent ventilator (a technician is currently flying in from Florida to administrate it) to see if it will help her get the needed oxygen she needs.  The technician should be here sometime this evening and the machine which is currently only 3 hours away will be here when she arrives. The staff is very excited about having this equipment for Michelle... X-ray came back that the lungs have gotten worse and one side probably isn't working at all.  She's had to get hand bagged (more pressure than respirator) several times throughout the night to increase flow. The hospital is trying everything to help with her battle. She is fighting with everything she has...

The oscillatory ventilator arrived at 10:45pm and Sue the technician from Augusta Georgia (but working in Florida) arrived around 11:00 pm.  Machine was hooked up immediately and her oxygen levels increased rapidly from the mid 70% to around the low 80's.  Then at 11:30pm a hose blew but that was quickly fixed.  Once back on the machine she started to increase gradually.

Check the Old News page previous days.

Diagnosis  High Risk B-Precursor Acute Lymphoblastic Leukemia

   
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Michelle Lunn